ASD Assessment & Diagnosis
Diagnosing Autism Spectrum Disorder (ASD) is challenging due to the absence of a definitive medical test like a blood test. The process involves examining the child’s behavior and developmental history.
ASD can be identified as early as 18 months, and by age 2, a diagnosis by a skilled professional is generally very reliable. However, many children are diagnosed at a later age, and some not until adolescence or adulthood. This delay can hinder early intervention, which is crucial for children with ASD.
Early signs of ASD may include avoiding eye contact, showing little interest in others, limited language skills, and getting upset by minor changes in routine. The CDC’s “Learn the Signs. Act Early.” program offers resources to help families track developmental milestones and identify developmental concerns, including ASD.
As they grow, children with ASD might struggle with forming and maintaining friendships, communicating effectively, and understanding expected behaviors in different settings. They may also have co-occurring conditions like ADHD, OCD, anxiety, depression, or conduct disorder.
It’s vital to monitor, screen, evaluate, and diagnose ASD as early as possible to ensure children receive necessary services and support. This involves several steps:
Developmental Monitoring This process observes your child’s growth and checks if your child is reaching typical developmental milestones in various areas. Caregivers, including parents and early childhood providers, can participate in this monitoring using checklists. If your child appears to be missing milestones, it’s important to discuss this with a healthcare provider.
During well-child visits, healthcare providers will also engage in developmental monitoring, observing and interacting with the child to assess milestone achievement. Any concerns identified might lead to a more thorough evaluation.
Developmental Screening This is a more formal process than monitoring, often involving a brief test or a questionnaire about the child. It’s conducted by healthcare or other professionals and is usually part of regular well-child visits at 9, 18, and 30 months, with additional ASD-specific screenings at 18 and 24 months. Children at higher risk for ASD or developmental problems might require additional screening.
Comprehensive Developmental Evaluation If a screening suggests concerns, a formal developmental evaluation may be necessary. This thorough evaluation is conducted by specialists like developmental pediatricians or speech-language pathologists. They might use structured tests, observations, and questionnaires to determine if a child needs special treatments or early intervention services.
For further information on developmental monitoring and screening, view and print a fact sheet from the CDC.
References:
- Lord C, Risi S, DiLavore PS, Shulman C, Thurm A, Pickles A. Autism from 2 to 9 years of age. Arch Gen Psychiatry. 2006 Jun;63(6):694-701.
- Hyman SL, Levey SE, Myers SM, Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics. 2020 Jan;145(1).
What does the CDC say about Autism?
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Identifying Autism Spectrum Disorder (ASD) can be challenging as it lacks a definitive medical test, such as a blood test, for diagnosis. Instead, physicians assess the child’s developmental and behavioral patterns to determine the presence of ASD.
ASD can potentially be identified as early as 18 months. By the age of 2, a diagnosis made by a skilled professional is generally regarded as highly dependable. Yet, a definitive diagnosis often comes much later for many children. This postponement in diagnosis can result in a delay in receiving early intervention, which is crucial for children with ASD.
At present, there is no known cure for Autism Spectrum Disorder (ASD). However, studies indicate that early intervention treatments can significantly enhance a child’s developmental progress. These early intervention services are aimed at children from birth to 3 years of age (36 months), focusing on developing vital skills. They may encompass therapies to assist the child in developing speech, mobility, and social interaction capabilities. Consequently, if you suspect your child might have ASD or any developmental issues, it is crucial to consult with your child’s healthcare provider promptly.
Children who have not been formally diagnosed with ASD might still be eligible for early intervention treatments. Under the Individuals with Disabilities Education Act (IDEA), children younger than 3 years (36 months) who are potentially at risk of developmental delays can qualify for these services. These are available through an early intervention system in each state, where you can request an evaluation for your child.
Furthermore, specific symptom treatments, like speech therapy for language delays, often do not require a formal ASD diagnosis before beginning.
The full range of causes for Autism Spectrum Disorder (ASD) remains unknown, but it is believed to arise from multiple sources, leading to various types of ASD. A combination of factors, including environmental, biological, and genetic influences, may increase a child’s likelihood of developing ASD.
It is widely accepted among experts that genetics play a key role as a risk factor in the development of ASD. The risk is higher for children who have a sibling diagnosed with ASD. Additionally, individuals with specific genetic or chromosomal disorders, like fragile X syndrome or tuberous sclerosis, are more prone to developing ASD.
Certain medications prescribed during pregnancy, namely valproic acid and thalidomide, have been associated with a heightened risk of ASD. Research suggests that the critical window for the development of ASD is around the time before, during, and immediately after birth. Furthermore, children of older parents face an increased risk of ASD.
ASD remains a critical issue in public health. The Centers for Disease Control and Prevention (CDC), along with families impacted by ASD, are dedicated to uncovering the causes of this disorder. Gaining a deeper understanding of what predisposes an individual to ASD is crucial. To this end, the CDC is conducting one of the most extensive studies in the U.S., named the Study to Explore Early Development (SEED). This study investigates various potential risk factors for ASD, encompassing genetic, environmental, pregnancy-related, and behavioral factors.
ASD affects individuals across all racial, ethnic, and socioeconomic backgrounds. However, it is observed to be approximately four times more prevalent in boys than in girls.
For more than ten years, the CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network has been tracking the prevalence of ASD among children in the United States. This monitoring has provided substantial insights into the number of U.S. children affected by ASD. Continuously employing these tracking methods over time is vital to understand the evolving trends and learn more about the nature of the disorder.